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Sirolimus may, however, have adverse vascular effects and has previously been shown to induce endothelial cell dysfunction and impaired nitric oxide production in vitro. Sirolimus-eluting coronary artery stents have been associated with rare reports of severe coronary artery vasospasm; however, systemic sirolimus therapy has not previously been associated with vasospastic complications.<\/jats:p>","DOI":"10.1136\/bcr-2021-243928","type":"journal-article","created":{"date-parts":[[2021,9,7]],"date-time":"2021-09-07T11:55:15Z","timestamp":1631015715000},"page":"e243928","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Inferior ST-elevation myocardial infarction secondary to coronary artery spasm in a patient on maintenance sirolimus postrenal transplantation"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3320-6980","authenticated-orcid":false,"given":"Mandeep Singh","family":"Kalsi","sequence":"first","affiliation":[{"name":"Department of Cardiology, Northern Hospital Epping, Melbourne, Victoria, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nalin","family":"Dayawansa","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Northern Hospital Epping, Melbourne, Victoria, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yanti","family":"Octavia","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Northern Hospital Epping, Melbourne, Victoria, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M Asrar","family":"ul Haq","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Northern Hospital Epping, Melbourne, Victoria, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2021,9,7]]},"reference":[{"key":"2025082702473856000_14.9.e243928.1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/16.8.1545"},{"key":"2025082702473856000_14.9.e243928.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2005.01.062"},{"key":"2025082702473856000_14.9.e243928.3","first-page":"218","article-title":"The effect of calcineurin inhibitors on endothelial and platelet function in renal transplant patients","volume":"76","author":"Sahin","year":"2011","journal-title":"Clin Nephrol"},{"key":"2025082702473856000_14.9.e243928.4","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1023\/A:1025339819051","article-title":"Multicenter prospective investigation on cardiovascular adverse effects of tacrolimus in kidney transplantations","volume":"17","author":"Seino","year":"2003","journal-title":"Cardiovasc Drugs Ther"},{"key":"2025082702473856000_14.9.e243928.5","doi-asserted-by":"crossref","first-page":"944","DOI":"10.1016\/j.bbalip.2014.03.014","article-title":"Inhibition of mTOR down-regulates scavenger receptor, class B, type I (SR-BI) expression, reduces endothelial cell migration and impairs nitric oxide production","volume":"1841","author":"Fruhw\u00fcrth","year":"2014","journal-title":"Biochim Biophys Acta"},{"key":"2025082702473856000_14.9.e243928.6","doi-asserted-by":"crossref","DOI":"10.1186\/s40001-015-0150-4","article-title":"Rapamycin impairs endothelial cell function in human internal thoracic arteries","volume":"20","author":"Reineke","year":"2015","journal-title":"Eur J Med Res"},{"key":"2025082702473856000_14.9.e243928.7","doi-asserted-by":"publisher","DOI":"10.1016\/S1053-2498(02)00429-1"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2021-243928","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T09:47:50Z","timestamp":1756288070000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2021-243928"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,9]]},"references-count":7,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2021,9,7]]},"published-print":{"date-parts":[[2021,9]]}},"alternative-id":["10.1136\/bcr-2021-243928"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2021-243928","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2021,9]]}}}